Nimotuzumab-vinorelbine combination therapy versus other regimens in the treatment of pediatric diffuse intrinsic pontine glioma

• Published in: Child's nervous system Vol. 40; no. 6; pp. 1671 - 1680
• Main Authors: Özkan, Ayşe, Yağcı Küpeli, Begül, Küpeli, Serhan, Sezgin, Gülay, Bayram, İbrahim
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2024
• Subjects: Adolescent; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Brain Stem Neoplasms - drug therapy; Child; Child, Preschool; Diffuse Intrinsic Pontine Glioma - drug therapy; Female; Humans; Infant; Male; Medicine; Medicine & Public Health; Neurosciences; Neurosurgery; Retrospective Studies; Temozolomide - administration & dosage; Temozolomide - therapeutic use; Treatment Outcome; Vinblastine - administration & dosage; Vinblastine - analogs & derivatives; Vinblastine - therapeutic use; Diffuse pontine glioma; Pediatric; Survival; Nimotuzumab; Vinorelbine; Medicamentous therapy
• ISSN: 0256-7040; 1433-0350
• DOI: 10.1007/s00381-024-06329-4

Purpose Pediatric diffuse intrinsic pontine glioma (DIPG) is a fatal disease associated with a median survival of < 1 year despite aggressive treatments. This retrospective study analyzed the treatment outcomes of patients aged < 18 years who were diagnosed with DIPG between 2012 and 2022 and who received different chemotherapy regimens. Methods After radiotherapy, patients with DIPG received nimotuzumab-vinorelbine combination or temozolomide-containing therapy. When nimotuzumab was unavailable, it was replaced by vincristine, etoposide, and carboplatin/cyclophosphamide (VECC). Temozolomide was administered as a single agent or a part of the combination chemotherapy comprising temozolomide, irinotecan, and bevacizumab. Furthermore, 1- and 3-year overall survival (OS), progression-free survival (PFS), and median OS and PFS were analyzed. Results The median age of 40 patients with DIPG was 97 ± 46.93 (23–213) months; the median follow-up time was 12 months. One and 3-year OS were 35.0% and 7.5%, respectively. Median OS was 12 months in all patients ( n  = 40), and it was 16, 10, and 11 months in those who received first-line nimotuzumab-vinorelbine combination ( n  = 13), temozolomide-based ( n  = 14), and VECC ( n  = 6) chemotherapy regimens, respectively ( p  = 0.360). One patient who received gefitinib survived for 16 months. Conversely, patients who never received radiotherapy and any antineoplastic medicamentous therapy ( n  = 6) had a median OS of 4 months. Conclusion Nimotuzumab-vinorelbine combination therapy prolonged OS by 6 months compared with temozolomide-containing chemotherapy, although the difference was not statistically significant.